Abstract

Objective: The study was conducted to assess the accuracy of clinical and quantitative methods against haeamtocrit for estimation of intra operative blood loss during caesarean section.
Study design: Comparative cross sectional study.
Place and Duration: Department of Obstetrics and Gynecology-unit II Pakistan institute of medical sciences Islamabad from July 2012 till Dec 2012.
Methodology: The study included 312 informed and consented term pregnant women who underwent caesarean section under spinal anaesthesia. Women receiving intra operative or postoperative blood transfusion and general anaesthesia were excluded. Blood loss estimation by clinical method was done by attending anaesthetist. Blood loss was estimated by quantitative method including visual assessment by attending obstetrician, gravimetric method by weighing of sponges and by change in hemoglobin using Flordal formula. All methods were compared against blood loss estimated through haeamtocrit (gold standard), done 24hrs after surgery.
Results: The mean blood loss estimated through clinical method was 809.142 ± 595 ml .Blood loss estimated through quantitative methods by visual estimation was 593.08±155.5 ml, by gravimetric method was 577.35±165.7ml and estimation through hemoglobin was 546.2±165.7ml respectively when compared against haeamtocrit, with estimated blood loss 341.01±338.9ml
Conclusion: The clinical method showed a significantly higher blood loss as compared to quantitative method. Both clinical and quantitative methods showed over estimation of blood loss when compared with haeamtocrit. All Quantitative methods were comparable with each other. Large scale study is recommended before the generalization of results.
Key words:  Blood loss, Caesarean section, Clinical method, Quantitative method.